Menopause Treatments

Menopause Treatments

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HRT

Hormone replacement therapy (HRT) is an effective treatment when it comes to addressing menopausal symptoms. It is designed to replace the hormones that a woman’s body no longer produces.

There are two main hormones used in HRT: oestrogen and progestogen. Depending on the stage of the menopause, symptoms and patient history, there are various ways to take HRT.

During the consultation, I will discuss treatment routes in more detail to find out which is right for you. If you do decide you would like to try HRT after our consultation I would usually encourage the use of body identical hormones (also known as regulated bio identical hormones) as these have the same molecular structure as the hormones that we naturally produce. They are derived from a chemical extracted from a tropical root vegetable (the yam).

Oestrogen-only HRT

Oestrogen-only HRT is only recommended for those who have had their womb removed during a hysterectomy.

Sequential HRT

Sequential HRT, also referred to as cyclical HRT, is often recommended for women who have symptoms but are still having their periods. In the treatment plan, oestrogen will be taken every day with the addition of progestogen taken two weeks every month.

Continuous combined HRT

Continuous combined HRT is usually suggested for women who are postmenopausal. It involves taking oestrogen and progestogen every day without a break.

HRT risks and benefits


Benefits

The key benefits of taking HRT, is the relief of menopausal symptoms including hot flushes, night sweats, weight gain, mood swings, vaginal dryness and reduced sex drive. It also helps to maintain collagen in the skin and can help with migraines and joint pains.

It can also be used as a preventative measure to help maintain healthy bones, connective tissues and reduce the risk of cardiovascular disease when started between 50 and 59 years of age. There is a possible reduction in the incidence of Alzheimer’s disease, and it can also reduce the risk of colon cancer.


Risks

Over the years, HRT has caused a lot of confusion and negativity however, it’s important to dispel the myths and provide clinical evidence to help put patients at ease. I’m more than happy to discuss any fears you may have at your appointment. I often use resources from the British Menopause Society and Women’s Health Concern to help with these discussions. You can find a few here:


Side effects

Most women tolerate HRT very well and often feel back to their normal selves within a few weeks to months. The most common side effects of taking oestrogen includes bloating, breast tenderness, feeling sick or leg cramps. Progesterone can also cause breast tenderness, headaches, mood swings, depression or acne.

Follow-up is included into the cost of the initial consultation fee so that you can easily discuss any concerns you may have. I can adjust your prescription accordingly.


Testosterone

Testosterone

Testosterone can be administered by gel and is typically recommended for those with a low libido. It also has an important role in energy levels, bone and brain health. Commonly it is used alongside another type of HRT.

It’s worth noting that there isn’t a licensed form of testosterone in the UK at present. However, it is prescribed by many menopause experts as it has proven benefits in numerous clinical trials.

There are usually no side effects with such treatment as it’s given to replace what you are otherwise lacking. Very occasionally, you can have excess hair growth in the area you rub the gel in.

To read more about the use of testosterone in women, view this handy fact sheet.

Vaginal cream

Vaginal cream


Oestrogen can be prescribed as a cream, pessary or ring that’s placed inside the vagina and can particularly help with vaginal dryness. Commonly it is used alongside another type of HRT.

There are usually no side effects with such treatment, and it does not carry the risks of usual HRT.

Alternatives to HRT

Alternatives to HRT

If you are unable to take HRT or simply don’t want to, I’m able to advise on how to manage symptoms through making healthier lifestyle choices. These include:

  • Doing regular exercise to help reduce hot flushes, boost your mood and improve sleep. There is evidence that regular practice of Yoga can improve sleep, anxiety and mood swings as well as muscle strength, flexibility and help with joint pains.
  • Eating a healthy balanced diet will ensure you are getting all of the right nutrients and vitamins for good health and prevent against weight gain. It is especially important at this time of life to eat enough calcium daily (700mg) and you may consider a supplement of vitamin D, especially in the winter months.
  • Avoiding spicy foods, alcohol and caffeine is also recommended as they can all cause hot flushes.
  • Trying to reduce stress levels is also advised as stress has a detrimental effect on the body and can heighten mood swings and anxiety.
  • Giving up smoking will help reduce hot flushes and the risk of developing serious health conditions.


Cognitive Behavioural Therapy (CBT) can be useful and there is more information about this here. This can be discussed in your appointment. There are also prescriptions that may be helpful if you cannot take HRT such as anti-depressants and a medication called Clonidine.

For more information on complementary and alternative therapy, you can check out this factsheet. All of the above can be discussed in your initial consultation.


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